Microsurgical decompression of the supraorbital nerve in the treatment of chronic neuropathic pain in the frontal-temporal area

Chronic headache is common. One of the causes of frontal-temporal pain may be compression of sensory nerves from the trigeminal nerve system, for example, the supraorbital nerve. Our study involved 12 women with symptoms of supraorbital nerve neuralgia resistant to drug correction. He underwent microsurgical decompression of the supraorbital nerve. The results of the operation were assessed by the change in the level of neuropathic pain using the PainDetect questionnaire and the degree of psychosocial maladjustment of the patient according to the MIDAS questionnaire, before and after the operation. The data obtained indicate a significant decrease in the level of neuropathic pain in patients 1 month after surgery and a significant minimization of the effect of headache on the quality of life in patients 3 months after surgery. Two out of 12 women did not notice any improvement, which required repeated delayed revision and extended proximal decompression of the supraorbital nerve with dissection of m. corrugator supercilii fibers. After the myotomy, pain regression was achieved and the patients noted that they were satisfied with the result.

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Investigation of the Correlation between Postherpetic Itch and Neuropathic Pain over Time

Pain Research and Management ◽

10.1155/2018/9305126 ◽

2018 ◽

Vol 2018 ◽

pp. 1-6 ◽

Cited By ~ 4

Author(s):

Rie Ishikawa ◽

Masako Iseki ◽

Rie Koga ◽

Eiichi Inada

Keyword(s):

Neuropathic Pain ◽

Herpes Zoster ◽

Pain Intensity ◽

Visual Analog Scale ◽

Analog Scale ◽

Paindetect Questionnaire ◽

Relationship Of ◽

The Relationship ◽

Over Time

Postherpetic itch (PHI), or herpes zoster itch, is an intractable and poorly understood disease. We targeted 94 herpes zoster patients to investigate their pain and itch intensities at three separate stages of the condition (acute, subacute, and chronic). We used painDETECT questionnaire (PDQ) scores to investigate the correlation between PHI and neuropathic pain. Seventy-six patients were able to complete follow-up surveys. The prevalence of PHI was 47/76 (62%), 28/76 (37%), and 34/76 (45%) at the acute, subacute, and chronic stages, respectively. PHI manifestation times and patterns varied. We investigated the relationship of PHI with neuropathic pain using the visual analog scale (VAS), which is a measure of pain intensity, and the PDQ, which is a questionnaire used to evaluate the elements of neuropathic pain. The VAS and PDQ scores did not differ significantly between PHI-positive and PHI-negative patients. A large neuropathic component was not found for herpes zoster itch, suggesting that neuropathic pain treatments may not able to adequately control the itch. Accordingly, we suggest that a more PHI-focused therapy is required to address this condition.

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HCN2 ion channels: basic science opens up possibilities for therapeutic intervention in neuropathic pain

Biochemical Journal ◽

10.1042/bcj20160287 ◽

2016 ◽

Vol 473 (18) ◽

pp. 2717-2736 ◽

Cited By ~ 23

Author(s):

Christoforos Tsantoulas ◽

Elizabeth R. Mooney ◽

Peter A. McNaughton

Keyword(s):

Chronic Pain ◽

Neuropathic Pain ◽

Ion Channels ◽

Warning Signal ◽

Sensory Nerves ◽

Nociceptive Neurons ◽

Pain Syndromes ◽

Medical Need ◽

Pathological Pain ◽

Genetic Deletion

Nociception — the ability to detect painful stimuli — is an invaluable sense that warns against present or imminent damage. In patients with chronic pain, however, this warning signal persists in the absence of any genuine threat and affects all aspects of everyday life. Neuropathic pain, a form of chronic pain caused by damage to sensory nerves themselves, is dishearteningly refractory to drugs that may work in other types of pain and is a major unmet medical need begging for novel analgesics. Hyperpolarisation-activated cyclic nucleotide (HCN)-modulated ion channels are best known for their fundamental pacemaker role in the heart; here, we review data demonstrating that the HCN2 isoform acts in an analogous way as a ‘pacemaker for pain’, in that its activity in nociceptive neurons is critical for the maintenance of electrical activity and for the sensation of chronic pain in pathological pain states. Pharmacological block or genetic deletion of HCN2 in sensory neurons provides robust pain relief in a variety of animal models of inflammatory and neuropathic pain, without any effect on normal sensation of acute pain. We discuss the implications of these findings for our understanding of neuropathic pain pathogenesis, and we outline possible future opportunities for the development of efficacious and safe pharmacotherapies in a range of chronic pain syndromes.

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Choroidal Volume Evaluation after Photodynamic Therapy Using New Optical Coherence Tomography Imaging Algorithm

Pharmaceuticals ◽

10.3390/ph14111140 ◽

2021 ◽

Vol 14 (11) ◽

pp. 1140

Author(s):

Miki Sato-Akushichi ◽

Shinji Ono ◽

Gerd Klose ◽

Youngseok Song

Keyword(s):

Photodynamic Therapy ◽

Choroidal Thickness ◽

Central Area ◽

Chronic Central Serous Chorioretinopathy ◽

Temporal Area ◽

Short Period ◽

Before And After ◽

History Of ◽

Optical Coherence Tomography Imaging ◽

Choroidal Volume

To evaluate choroidal volume and thickness changes after photodynamic therapy (PDT) for chronic central serous chorioretinopathy (CSC). Chronic CSC eyes with a history of PDT were selected. Average choroidal volume, average choroidal thickness, the maximum and minimum choroidal thickness of the macula irradiated area and peripheral non-irradiated areas before and after one and three months of treatment were examined. A total of 14 patients with chronic CSC and 9 controls without any eye pathology were enrolled. The mean choroidal volume in CSC before and, and after one and three months of treatment were 2.36 (standard deviation: 0.70), 1.90 (0.69), 1.86 (0.66) mm3 for the central area, 1.25 (0.38), 1.14 (0.35), 1.13 (0.34) mm3 for superior nasal area, 1.47 (0.41), 1.28 (0.43), 1.26 (0.43) mm3 for superior temporal area, 1.07 (0.49), 0.95 (0.38), 0.93 (0.35) mm3 for inferior nasal area, 1.17 (0.38), 1.04 (0.32), 1.03 (0.33) mm3 for inferior temporal area. This study revealed the choroidal volume changes in a short period after PDT and a decrease in unirradiated choroidal volume was also shown after the treatment. The algorithm provided on the ARI Network enables to evaluate the choroidal changes quantitatively and qualitatively.

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EFFECTIVENESS OF GABAPENTIN USAGE TOWARD REDUCING PAIN INTENSITY LEVEL AND QUALITY OF LIFE OF POST-STROKE NEUROPATHIC PATIENTS IN REGIONAL GENERAL HOSPITAL, WEST NUSA TENGGARA PROVINCE YEAR 2018

Asian Journal of Pharmaceutical and Clinical Research ◽

10.22159/ajpcr.2019.v12i3.31035 ◽

2019 ◽

pp. 560-562

Author(s):

NURUL QIYAAM ◽

WIRAWAN ADIKUSUMA ◽

BAIQ LENY NOPITASARI ◽

TRI MURTI ANDAYANI ◽

AULIA AMINI

Keyword(s):

Quality Of Life ◽

Neuropathic Pain ◽

Pain Intensity ◽

General Hospital ◽

Intensity Level ◽

Post Stroke ◽

Provincial Hospital ◽

Before And After ◽

June July

Objective: Stroke is defined as a sudden loss of brain function due to blockade/rupture of the brain’s blood vessels. Data collected by the Indonesian Stroke Foundation show that Indonesia ranks first in Asia as the country with the highest number of stroke sufferers. The purpose of this study was to determine the effectiveness of the use of gabapentin to reduce pain intensity and improve the quality of life of post-stroke neuropathic pain in NTB Province hospital patients. Methods: This study was carried out in the period of June–July 2018. The targeted population was all post-stroke neuropathic patients who received gabapentin therapy in NTB provincial hospital. Affordable populations are post-stroke neuropathic pain patients who seek outpatient treatment at NTB provincial hospital that meets the inclusion and exclusion criteria. The results of the data will be analyzed using paired sample t-test. Obtained 15 patients were willing to participate in this study. Results: The results of the study using questionnaire EQ-5D-3L after using gabapentin for 2 weeks. Patients experienced an improvement in the quality of life in each dimension items, namely the ability to walk/move from 6.7%, no problem to 60%, no self-care, 26.7% no problem to be 80% without problems, usual activities carried out from 13.3% had no problems to 46.7% had no problems, feeling of pain/discomfort from 60% having moderate problems to 60% had no problems, and anxiety/depression of 60% had no problem being 100% has no problem. While the measurement of the quality of life using the EQ-VAS questionnaire, there was a significant improvement in the quality of life between before and after using gabapentin at 32.66. Conclusion: The use of gabapentin has effectiveness on reduction of pain intensity and the quality of life of post-stroke neuropathic patients in regional general hospital, West Nusa Tenggara Province year 2018.

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Role of Exercise Activity in Alleviating Neuropathic Pain in Diabetes via Inhibition of the Pro-Inflammatory Signal Pathway

Biological Research For Nursing ◽

10.1177/1099800418803175 ◽

2018 ◽

Vol 21 (1) ◽

pp. 14-21 ◽

Cited By ~ 2

Author(s):

Xiao-Qiu Ma ◽

Jing Qin ◽

Hong-Yan Li ◽

Xiu-Li Yan ◽

Yong Zhao ◽

...

Keyword(s):

Neuropathic Pain ◽

Tumor Necrosis ◽

Signal Pathway ◽

Sensory Nerves ◽

Glucose Levels ◽

Tnf Α ◽

Exercise Activity ◽

Necrosis Factor ◽

Pro Inflammatory Cytokines

Hyperalgesia and allodynia are commonly observed in patients with diabetic neuropathy. The treatment and management of painful peripheral neuropathy is important in these patients. The purpose of this study was to examine the role of exercise in modulating neuropathic pain induced by diabetes. Diabetes was induced in rats by an intraperitoneal injection of streptozotocin (STZ). Control rats received saline injections. Groups included control rats without exercise (NT-control, n = 12), control rats with exercise (EX-control, n = 16), STZ rats without exercise (NT-STZ, n = 18), and STZ rats with exercise (EX-STZ, n = 22). Rats in EX groups ran on a treadmill 4 days/week for 5 weeks beginning from the week of STZ administration. Mechanical hypersensitivity (mechanical paw withdrawal thresholds [PWTs]) and glucose levels were tested weekly. Then, enzyme-linked immunoassay and Western blot analysis were used to determine the levels of pro-inflammatory cytokines (PICs) and their receptors in sensory nerves. PWTs were significantly increased after 4–5 weeks of exercise in STZ rats ( p < .05 vs. NT-STZ rats). Inhibition of neuropathic pain by exercise in STZ rats was accompanied by decreases in interleukin (IL)-1β, IL-6, and tumor necrosis factor (TNF)-α levels and downregulated expression of their receptors. Furthermore, blocking individual PIC receptors elevated PWTs to a greater degree in STZ rats ( p < .05 vs. control rats). Overall, our data suggest that exercise can play a role in improving neuropathic pain induced by STZ and that PIC signaling is a part of the mechanism involved in this effect.

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Docosanoid signaling modulates corneal nerve regeneration: effect on tear secretion, wound healing, and neuropathic pain

The Journal of Lipid Research ◽

10.1194/jlr.tr120000954 ◽

2020 ◽

pp. jlr.TR120000954 ◽

Cited By ~ 2

Author(s):

Thang L. Pham ◽

Haydee E.P. Bazan

Keyword(s):

Wound Healing ◽

Neuropathic Pain ◽

Nerve Regeneration ◽

Contact Lenses ◽

Therapeutic Option ◽

Pigment Epithelium ◽

Nerve Damage ◽

Sensory Nerves ◽

Tear Secretion ◽

Corneal Nerve

The cornea is densely innervated, mainly by sensory nerves of the ophthalmic branch of the trigeminal ganglia (TG). These nerves are important to maintain corneal homeostasis, and nerve damage can lead to a decrease in wound healing, an increase in corneal ulceration and dry eye disease (DED), and neuropathic pain. Pathologies, such as diabetes, aging, viral and bacterial infection, as well as prolonged use of contact lenses and surgeries to correct vision can produce nerve damage. There are no effective therapies to alleviate DED (a multifunctional disease) and several clinical trials using ω-3 supplementation show unclear and sometimes negative results. Using animal models of corneal nerve damage, we show that treating corneas with pigment epithelium-derived factor (PEDF) plus docosahexaenoic acid (DHA) increases nerve regeneration, wound healing, and tear secretion. The mechanism involves the activation of a calcium-independent phospholipase A2 (iPLA2ζ) that releases the incorporated DHA from phospholipids and enhances the synthesis of docosanoids neuroprotectin D1 (NPD1) and a new resolvin stereoisomer RvD6i. NPD1 stimulates the synthesis of brain-derived neurotrophic factor (BDNF), nerve growth factor (NGF), and of semaphorin 7A (Sema7A). RvD6i treatment of injured corneas modulates gene expression in the TG resulting in enhanced neurogenesis; decreased neuropathic pain and increased sensitivity. Taken together, these results represent a promising therapeutic option to re-establish the homeostasis of the cornea.

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Comparison of neuropathic pain characteristics associated with total brachial plexus injury before and after surgical repair: A retrospective study

Clinical Neurology and Neurosurgery ◽

10.1016/j.clineuro.2020.105692 ◽

2020 ◽

Vol 191 ◽

pp. 105692

Author(s):

Jinding Guo ◽

Kaiming Gao ◽

Yingjie Zhou ◽

Xin Zhao ◽

Jie Lao

Keyword(s):

Neuropathic Pain ◽

Retrospective Study ◽

Brachial Plexus ◽

Surgical Repair ◽

Brachial Plexus Injury ◽

Before And After ◽

Pain Characteristics

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On the pharmacological effects of two lidocaine concentrations tested on spontaneous and evoked pain in human painful neuroma: A new clinical model of neuropathic pain

Scandinavian Journal of Pain ◽

10.1016/j.sjpain.2013.07.012 ◽

2013 ◽

Vol 4 (4) ◽

pp. 258

Author(s):

Adriana Miclescu ◽

Björn Hägglöf ◽

Martin Schmelz ◽

Torsten Gordh

Keyword(s):

Neuropathic Pain ◽

Clinical Symptoms ◽

Control Level ◽

New Drugs ◽

Spontaneous Pain ◽

Double Blind ◽

Clinical Model ◽

Analgesic Effects ◽

Proposed Model ◽

Before And After

AbstractAimsSpontaneous and evoked pains are key symptoms of patients with neuropathic pain and there is a current discussion on the predictive value of evoked pain read outs for the reduction of spontaneous pain. Here we describe a new clinical model of neuropathic pain that may be useful for evaluation of new drugs. We also report the effects of lidocaine in this model as reference values.MethodsIn a randomized double-blind experiment, the analgesic effects of local lidocaine were investigated separately for spontaneous pain and for stimulus-evoked allodynia and hyperalgesia in sixteen patients with painful neuromas after traumatic nerve injuries in the upper extremities. The patterns of sensory changes were compared before and after treatment with lidocaine (0.1% or 0.5%, 1 ml), with 1–2 weeks interval, injected close to the neuroma. Spontaneous and evoked pains were assessed using a visual analogue scale (VAS) and quantitative/qualitative sensory testing.ResultsLidocaine dose-dependently reduced spontaneous and evoked pain scores by more than 90% with maximum effects between 1 and 5 min for evoked pain and between 3 and 15 min for spontaneous pain. While evoked pain normalized rapidly reaching about 50% of the control level 20 minutes after the injection spontaneous pain levels were lower than 25% at this time. Moreover, in 4 patients the reduction of ongoing pain lasted 24 h whereas evoked pain had returned to baseline levels in all the patients after 1 h.ConclusionDifferential analgesic effects of local lidocaine on spontaneous and evoked pain suggest that different mechanism underlie these two key clinical symptoms. Thus, clinical trials assessing localized traumatic neuropathic pain should investigate both aspects of pain separately with the proposed model allowing testing of new drugs systemically or locally administered.

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Neuropathic pain in patients with haemophilia, that is the question

Hämostaseologie ◽

10.1055/s-0037-1619823 ◽

2015 ◽

Vol 35 (S 01) ◽

pp. S5-S9 ◽

Cited By ~ 6

Author(s):

S. Krüger ◽

T. Hilberg

Keyword(s):

Rheumatoid Arthritis ◽

Chronic Pain ◽

Neuropathic Pain ◽

Differential Diagnosis ◽

Pain Management ◽

Pain Mechanisms ◽

Number Of Patients ◽

Paindetect Questionnaire ◽

Chronic Disorders ◽

Chronic Pain Conditions

SummaryChronic pain caused by recurrent joint bleedings affects a large number of patients with haemophilia (PwH). The basis of this pain, nociceptive or neuropathic, has not been investigated so far. In other pain-related chronic disorders such as osteoarthritis or rheumatoid arthritis, initial studies showed nociceptive but also neuropathic pain features. 137 PwH and 33 controls (C) completed the painDETECT-questionnaire (pDq), which identifies neuropathic components in a person´s pain profile. Based on the pDq results, a neuropathic pain component is classified as positive, negative or unclear. A positive neuropathic pain component was found in nine PwH, but not in C. In 20 PwH an unclear pDq result was observed. In comparison to C the allocation of pDq results is statistically significant (p≤0.001). Despite various pDq results in PwH and C a similar appraisal pain quality, but on a different level, was determined. Summarising the results, there is a potential risk to misunderstand underlying pain mechanisms in PwH. In chronic pain conditions based on haemophilic arthopathy, a differential diagnosis seems to be unalterable for comprehensive and individualised pain management in PwH.

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